'Very strong probability a wave is starting'

The leader of the Medical University of South Carolina’s COVID-19 Epidemiology Intelligence Project predicts that in two to three weeks, we’ll start seeing what he called big case numbers. “The trend on the map is moving in our direction. So it's starting to look like there’s a very, very strong probability a wave is starting,” said Michael Sweat, Ph.D. 

The national map shows virus hotspots getting closer and closer to South Carolina as case numbers here rise. Sweat, a professor in MUSC’s College of Medicine, an adjunct professor at the Johns Hopkins Bloomberg School of Public Health and a former research scientist with the Centers for Disease Control and Prevention, said we may be at the start of a new two-month cycle. “I just feel like it's coming. Seems the signal is stronger and stronger.”

Sweat’s COVID-19 team tracks four parts of the state, all of which have MUSC Health hospitals. In the Charleston Tri-county area, MUSC’s home base, cases were up 188% compared with the previous week in the team’s most recent update. In the Florence area, cases were up 102%. In the Lancaster area, they were up 44%. And in the Midlands, they were up 148%. His team will release new weekly numbers on Thursday, Dec. 16. 

 

While the numbers are still relatively low, Sweat said this is an important window of time. “Now is when you ought to be most careful, from a public health perspective, if we want to stop this and keep lots of people from getting infected. And it's paradoxical, because right now is when it's least likely people are going to do it, because numbers have been low and most people aren’t aware this is likely to happen.”

To avoid getting COVID, the Centers for Disease Control and Prevention recommends getting vaccinated and wearing a mask indoors if you aren’t fully vaccinated. If you live somewhere with a lot of COVID cases, the CDC suggests that you also wear a mask outdoors if you’re in a crowd and/or around people who aren’t fully vaccinated.

The current case increases Sweat’s team is tracking are Delta-driven. The Omicron variant, first identified in Africa last month, is a new factor. Its remarkable ability to spread already has health authorities in Europe warning that it will soon dominate Denmark and Norway. Omicron has showed up in the U.S., too, and it’s starting to surge in Washington state. 

Sweat said an analysis out of South Africa found Omicron was 2 1/2 times more transmissible than the Delta variant. “That puts its R naught, a measure of transmissibility, at something similar to measles, which is one of the most contagious things out there.” 

“So the news with Omicron is, it transmits fast. That's pretty solid. But the severity seems to be lower. That's not certain, but it’s leaning that way. So what does that mean?” Sweat asked.

“Over the long haul, Omicron could take over from Delta as a less severe illness. You could think of it as all these people who've not been vaccinated are going to get vaccinated through the infection and could suppress things down on the other side too. But it could still overrun the health system. It’s not clear what Omicron’s going to do. It could be good, it could be bad.”

What is clearly good is the fact that the hospitalization rate for COVID is much lower than in the early days of the pandemic. Vaccines and booster shots are making a big difference, Sweat said. And a lot of people have already had COVID, which may reduce their risk of getting really sick.

Sweat was also encouraged by news about Pfizer’s new antiviral pill, Paxlovid. “It was 89% effective at stopping hospitalization and death among high-risk people. I think by the end of January, we'll probably see that approved. That'll be a huge game changer. It'll lower infection rates. Hopefully people won't be as infectious and it'll make people not go in the hospital. It'll be a big, big thing. So that's very reassuring.”

As a lot of people prepare to visit family and friends over the winter holidays, Sweat had some advice. “Don't wait for a winter wave to happen. Be aware that we're on that path. It's going to get amplified by Christmas and Kwanzaa, right? There's a lot of parties and getting together and going out and traveling and that's like shaking a snow globe. It will mix people up and a lot of transmission can happen.”